The impact of tendonitis and RSI/WMSD on HRQoL according to gender: a population based study

Abstract

RTA survivor's characteristics. Psychological support to those at risk may prevent psychological disorders after a RTA. Key messages: Along with evaluation and treatment of road traffic accidents injuries, health care providers should evaluate pre-accident health status of all road traffic accidents victims. Understanding factors that present risk for poor mental health outcomes after the road traffic accidents is the key step in planning and organizing recovery of accidents survivors. Forgoing health care is associated with insurance deductibles in a consumer-driven health care system Background: The Swiss health care system is consumer-driven with universal coverage and good population outcomes. Deductibles of mandatory insurance plans are self-selected, regulated, and unrelated to pre-existing conditions. In a Swiss population, we aimed to determine if forgoing health care was associated with insurance plan deductibles and if the association was dependent on socioeconomic status. Methods: We used data from the Bus Santé Study; a cross-sectional survey study ongoing in Geneva (Switzerland) since 1993. We included adult participants in the study between 2007 and 2016. We divided participants according to insurance plan deductibles (low, medium, or high). Forgoing health care information was obtained from the study questionnaire. Forgoing dental health care was considered separately as mandatory insurance plans do not cover dental care. Inequalities were quantified using the regression-based relative index of inequality (RII) adjusted for potential confounders (age, gender, income, educational attainment, known comor-bidities, cardiovascular risk factors, additional health insurance plans or subsidized premiums) Results: We included 9081 participants, with 8.9% reporting forgoing non-dental healthcare. Those with a high-deductible insurance plan were younger, more often Swiss and male, with higher income and educational attainment, less known cardiovascular risk factors and comorbidities. Participants with high-deduc-tible plans had a higher probability of forgoing non-dental health care (RII=2.2, p < 0.001) independently of socioeconomic status and known comorbidities or cardiovascular risk factors. As expected, we did not observe inequalities related to insurance plan deductibles in forgoing dental health care (RII=1.0, p = 0.8). Conclusions: In a population with universal coverage and good health outcomes, insurance plan deductibles are associated with inequities in forgoing health care independently of socioeconomic status and pre-existing conditions. Key messages: In a highly performant health system, high insurance plan deductibles are associated with inequities in care independent of individual sociodemographic characteristics, risk factors and comorbidities. Uncovering associations between health system design features and inequities in care could inform decision-makers that seek to curtail inequities through improving their current health system design. Background: Repetitive Strain Injury (RSI)/Work-related Musculoskeletal Disorders (WMSD) and tendonitis are considered a serious problem in the area of Occupational Health. The present study aims to estimate the prevalence of these disorders on the adult population of a metropolis in the state of São Paulo and to analyze their impact on Health-Related Quality of Life (HRQoL), according to gender. Methods: A population-based cross-sectional study was conducted using data from the ''Campinas City Health Survey (ISACamp 2014/ 15)''. The sample consisted of 2,166 individuals aged 18 years or older and the SF-36 instrument was used for HRQoL analysis. The association between the variables was verified by the chi-square test and the Poisson simple and multiple regression models were used to estimate the prevalence ratios (PR). In HRQoL estimates, the average SF-36 scores were calculated according to the independent variables. Results: The prevalence of tendonitis and RSI/WMSD was 8.5%, with 6.7% tendonitis and 2.7% RSI/WMSD. The prevalence was higher among women (11%; 1.34-2.56), on individuals aged between 40-59 years (PR = 3.63; 2.28-5.80), who were on occupational activity (PR = 2.04; 1.12-3.68) or on work leave (PR = 7.07; 2.77-18.03) and on the most educated (PR = 2.45; 1.28-4.70). Subjects with these morbidities decreased in 6 of the 8 HRQoL domains and on stratification by gender, we observed that women had greater decreases in mental component scores in the presence of RSI/WMSD and men in physical component (p < 0.05). Conclusions: The diseases analyzed can affect men and women differently, and it is essential to consider the peculiarity of the impact between the sexes in the elaboration of interventions and preventive measures aimed at improving the quality of life. Key messages: No population-based studies were found that assess the impact of RSI/WMSD on HRQoL, according to gender differences, showing the relevance of this study. It is very important to understand how these diseases affect men and women differently so that specific and more effective preventive and rehabilitative measures can be carried out.